Roy Hodgson recalls the feeling well. It is five years since he last prepared for a major tournament — the fourth into which he had led a national team over his nomadic coaching career — but, even now, the memory of wincing through virtually every Premier League fixture of the domestic run-in before two European Championships and a World Cup with England remains raw.
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“An anxious time, always an anxious time,” he offers through a wry smile. “I mean, it was trickier with Switzerland back in 1994 because we had a very limited group of players, no more than 14 or 15 who saw us through qualification and the finals itself. With England, there were slightly more options in those three other tournaments, but you are forever on tenterhooks. So yes, ‘wincing’ is about right.”
It was always the sense of helplessness that grated.
As an outsider with a vested interest, his angst would rise with each challenge that flew in on a prospective pick. Every on-field grimace from one of his likely squad selections provoked shivers of apprehension from the national side’s delegation watching on from their seats in the stand. The post-match enquiries with club managers for updates on a player’s recovery programme — or the state of a tweaked hamstring, torn ankle ligament or broken foot — would be lodged with trepidation. The response, if downbeat, always had the potential to wreck those best-laid plans almost two years in the shaping.
Even if the Football Association’s medical staff considered a player fit, there was always the risk of his club employers begging to differ. Or at least being warier. The politics around the assessment of recovery can be delicate, with disagreements quickly escalating into full-scale diplomatic incidents.
The story goes that when Fabio Capello sought to include Owen Hargreaves, a player who had managed a solitary minute of Premier League football in 20 months for Manchester United after major surgery on both knees to cure a tendinitis problem, in his squad for the 2010 World Cup, he found himself cornered by a less than impressed Sir Alex Ferguson at a League Managers’ Association dinner a few days before the squad announcement. When the squad for South Africa was subsequently confirmed — surprise, surprise — Hargreaves was not in it.
Welcome to the reality of life as a national team manager over the long, treacherous build-up to a summer tournament.
Gareth Southgate has been here before and is only enduring what Hodgson, Capello and Sven-Goran Eriksson suffered over the last two decades. The state of Harry Kane’s ankles has been constant cause for concern over the final week of the domestic season but while he appears to have made it through unscathed, for other key England players the campaign still has a week to run as Manchester City, Chelsea, and Manchester United compete in UEFA’s Champions League and Europa League finals. Southgate, although welcoming the chance for players to play on the ultimate club stage, has effectively been condemned to another week of worry.
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Even if all come through unscathed, there are already fitness concerns over others aspiring to take part in the summer’s European Championships. Declan Rice and Jack Grealish have only recently returned, but some within the England camp’s fears that Jordan Henderson, such a mainstay of this team, would not be properly fit to feature at best until the pre-tournament warm-up friendly fixtures against Austria and Romania in Middlesbrough next month have rung true. There are also concerns over Harry Maguire, whose ankle injury looks highly likely to rule him out of Manchester United’s Europa League final, Kalvin Phillips, the Leeds midfielder who suffered a shoulder injury on the final day, and Nick Pope, the Burnley goalkeeper who is having minor knee surgery.
Southgate will have decisions to make on their selection.
Is it realistic to expect any player to be match fit for their country if they have not had a sustained, recent run for their club? These are familiar dilemmas.
For the management and medical staff at the FA, the period from qualification being secured to the pre-tournament squad announcement is actually the most hectic. “It’s when you’re at your busiest and when you lean most on the relationships you’ve built up over time, or renewed each year given the turnover at clubs, with your peers up and down the Premier League,” says Gary Lewin, who headed the national team’s medical team at five World Cups and four European Championships between 1996 and 2016. “Once the draw is made and you have a better idea of the logistics, in terms of travel, you have internal meetings. Gareth will have done this with his staff pre-Christmas.
“He probably would have drawn up a list of between 35 and 45 names, which gets whittled down to around 30 a lot closer to the tournament. His medical staff would then be given instructions, ‘Right, I want you to monitor these players now for the next six months’. So you’re talking to the medical staff at every club involved every week, in pre-COVID-19 times, going round to the clubs and talking to the players, monitoring their recovery or general fitness. Don’t get me wrong: you have absolutely no influence on the clubs. But, if your relationship is good, you’re talking and working in conjunction with the teams, but not in a hands-on fashion. More at a distance. How are things? If they are carrying injuries, how is their rehab progressing? What preventative measures are being taken to avoid a relapse, and what are their thoughts about the return to training, or even to playing?
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“You’re also finding out what equipment they’re using, what diets they’re on, what nutrition they’re on, what their sleeping patterns are. You’re building up a big medical profile of every player that may be selected. And, all the while, (the elite football physiotherapist for Perform at St George’s Park) Steve Kemp will be keeping Gareth updated.
“Meanwhile, and again without trying to influence things, Gareth will be having the same constant dialogue with the managers and coaches at the clubs. He’s gathering his own information to understand their thought process. It’s all about building up the most complete picture of the players’ fitness. But if you pick up a significant injury that’s going to impact upon the tournament, that’s when you have decisions to make.”
Those invariably revolve around the team’s perceived star performers. The nation almost went into mourning after Aldo Duscher, Deportivo La Coruna’s uncompromising Argentinian midfielder, crunched brutally into David Beckham in a Champions League quarter-final in April 2002 and cracked the second metatarsal in the Manchester United player’s left foot. England’s first World Cup group game was seven and a half weeks away. Beckham was the national captain, the talisman whose late free kick against Greece had secured passage to Japan. Duscher was not even booked for the challenge. The United player departed down the tunnel on a stretcher in agony and left the country in a tailspin.
Suddenly, metatarsals were all the rage. The Sun newspaper’s front page carried a photograph of Beckham’s foot, headlined “Beck us pray”, and urged readers to “lay your hands on David’s foot at noon and make it better”. The psychic entertainer Uri Geller appeared on breakfast television and told viewers to touch the screen and “send him healing energies, visualise the bone knitting together, unleash your healing powers, send the energy to that foot”. Not to be outdone, a Downing Street spokesman suggested the prime minister Tony Blair, ever the populist, had interrupted a cabinet meeting convened to discuss the Budget and the ongoing crisis in the Middle East to stress “nothing was more important” to England’s preparations than the state of Beckham’s foot.
As it transpired, Beckham’s recovery was speedy and he started the opening game against Sweden. Although he did not wield the same influence as he had when fully fit in qualifying, he scored the only goal from the penalty spot to beat Argentina. That winner was dressed as personal redemption for his dismissal against those same opponents in Saint-Etienne four years earlier, and felt even more appropriate given Duscher had been his assailant.
The gamble in selecting Wayne Rooney, another victim of the metatarsal curse after a challenge from Chelsea’s Paulo Ferreira at the end of April 2006, proved less fruitful. Ferguson was never comfortable with Eriksson’s desire to pick the striker, who watched the remainder of the campaign with his foot in a removable plastic cast. Indeed, the Swede recently relayed an early morning ear-bashing he received from the irate Manchester United manager at the time in which he was warned not to pick Rooney or “I will kill you, you are finished”. Eriksson claims to have told Ferguson to “fuck off”, wished him a pleasant summer holiday and, having insisted he would select the young striker, ended the phone call with a curt “ciao”.
There was an acceptance that Rooney stood no chance of playing in the first of England’s group games at the tournament in Germany. But the FA’s dilemma was that the forward had illuminated Euro 2004 and, if fit and focused, appeared to be the player around whom the team might build a coherent challenge later in the finals. The striker, too, was desperate to feature for his country. “It became a circus with Wayne coming to Germany with the squad, then flying back to Manchester for another scan,” says Adrian Bevington, who spent 17 years in various roles at the FA and rose to be managing director of Club England in 2010. “I understood both sides of the debate, even at the time.
“I could see why United were so worried because they felt the player was never going to be close to match fit. But if you’re the England manager, you want one of your very best players — a talismanic figure — in the squad if you think there’s any chance of him being available at some point. It’s a perfect storm.”
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The player was eventually assessed by independent specialists, professors Angus Wallace and Chris Moran having been summoned to Germany from the Queen’s Medical Centre in Nottingham by the England doctor Leif Sward. They studied footage of Rooney in full-contact training, spoke with the England fitness coach Ivan Carminati and determined the player was “available to play in the World Cup” and “no more at risk than any other player who has recovered from an injury and is returning to competitive sport”.
“We lived that story every day in the newspapers, whether he would be fit or not,” says Lewin. “But behind the scenes, we’d been constantly talking to the Manchester United medical team since the end of April, liaising with them, and got the professors over from Nottingham to do the final assessments. Everyone was actually quite happy internally with the way it was being dealt with. There’s not a medic in the world who would put a player at risk of long-term injury. But, as with anything, sometimes these decisions are made and the player comes back and he’s not quite right.”
Rooney came on for the last half hour of a win over Trinidad & Tobago, was visibly upset at being withdrawn after 69 minutes of the draw with Sweden, and laboured through the knockout victory over Ecuador. His dismissal in the quarter-final against Portugal — for what was deemed a deliberate stamp on Ricardo Carvalho — was put down to frustration at his rustiness. The player himself admitted last year in his column in the Sunday Times that he had actually torn his groin before his first training session back with the squad after breaking away from a light jog around the training pitch to belt a stray football at a distant crossbar.
“I got one of the physios to work quietly on it every day,” he said. “I was taking painkillers. I didn’t want to say anything because a lot of people had put a lot of work into getting me fit. I didn’t report the injury until the tournament was over — and there was a 6cm tear in my groin. Looking back, I should never have gone to that World Cup. In the same position again, I’d rule myself out. But back then I was 20, it was my first World Cup and there was so much expectation on me.”
It is easy to assume that, if a player’s club football has been severely disrupted ahead of a tournament, he will not be in a position to flourish at the finals proper. Rooney has claimed as much after his preparations for the 2010 World Cup were hampered by ankle problems, putting a dampener on a prolific campaign. He rather snarled his way through the national team’s underwhelming showing in South Africa.
Bryan Robson, the national captain, took pre-existing conditions to the Mexico and Italy World Cups in 1986 and 1990 and, after suffering relapses, did not see out either group stage. Hodgson had similar issues with key squad members in the build-up to all three of his tournaments in charge of England, and not all the problems were physical. “At Euro 2016, we were trying to get Ross Barkley fit and Jordan Henderson had been fighting off a nasty knee injury,” he tells The Athletic. “Jack Wilshere had broken his foot and hardly played for Arsenal in the months ahead of the 2014 World Cup, and had only started one Premier League game for his club in the season leading up to Euro 2016.
“We knew it wasn’t ideal. We wanted these guys to be at their very best, at peak fitness, and they weren’t. But I took those players because they were the lads we’d been working with for two years. They knew what we were trying to do and I believed in their quality. On top of that, of course, Raheem Sterling had been going through a torrid time at Manchester City back in 2016 and when he came to us, even though he wasn’t physically injured, his mental state at the time was not as it should be.
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“And we had the unfortunate situation with the (five) Tottenham players that year who, for a long period, looked as if they were going to win the Premier League only to fall away very badly. That didn’t do Harry Kane and Dele Alli, two players we’d been counting on to bring us through when the times got tough, any good at all. Their mental state at the time wasn’t quite as good as it should have been because they had been battered by the fact they’d got so close to winning a glittering prize and didn’t quite get it at the last minute.”
It is not always only battered bodies that need healing.
Hodgson had to make judgement calls on players he trusted. From the outside looking in, it was easy to pick holes in the arguments to retain personnel who had hardly featured for their clubs. “But these things are so subjective,” says Lewin. “Sometimes they come back and are fit, but because results don’t go well people see things in the performances that aren’t there. If you get knocked out, the easy thing is to say they weren’t right. Other times, their return might arguably be the wrong decision, but because the team are winning… you have 11 pieces of a jigsaw and one of them, coming back from injury, could actually have done quite well. But if the other parts of the jigsaw aren’t quite right, the one thing people point to is the player coming back ‘not looking at it’.
“Every player is completely different. There are some players who, having been out for three months, come back and don’t look the same. People often say Kane looks rusty in his first two or three games back after a lay-off, but then, with the flick of a switch, he’s on fire again. Luis Suarez had surgery to repair the meniscus in his knee before the 2014 World Cup, but came back against us in the second group game and knocked us out. Was anyone in Uruguay questioning that decision then? Or was his injury only brought up after what happened in the last group game (when a frustrated Suarez bit Italy’s Giorgio Chiellini)?
“And I’ll throw another at you: how do people perceive how Tony Adams did at Euro ’96? He’d hardly played for six months (after surgery to remove cartilage in his knee), had 45 minutes in a friendly in Hong Kong, and then didn’t miss a game at the Euros. In the eyes of most onlookers, he played some of the best football of his career. There’s no catch-all to this.
“All you can do is gather all the relevant information, as we did with Rooney, and work out when these players will be able to play again. Then you have to weigh up whether they can contribute meaningfully or not.”
A prime example was Michael Owen in 2006. The Newcastle United striker’s first season back in the Premier League after a solitary campaign with Real Madrid had been stalled by a fractured metatarsal, suffered in a collision with his England team-mate Paul Robinson in a loss at Tottenham Hotspur on New Year’s Eve. The bone failed to knit together properly, prompting a second operation in February to remove the original screw and fit another. The surgeon assured Owen he would be fit again for May.
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“But there’s fitness and there’s fitness,” he later told the Telegraph. “If I am being objective about it now, I should have ruled myself out and concentrated on getting fit for the next season. But objectivity is the last quality you have as an injured footballer.”
The 29 minutes mustered as a substitute at Birmingham in late April constituted his only competitive football for his club over the remainder of the term. He featured in pre-tournament games against Hungary and Jamaica, and for England B against Belarus, and persuaded Eriksson he was worth the risk for the squad, yet privately likened his control in those fixtures to “playing with a rugby ball”. He started all three group games in the finals proper, only to rupture his anterior cruciate knee ligament early in the third fixture, against Sweden. “My leg had been in a pot. I was not putting weight on it for four or five months, which meant I went into the World Cup with one leg not conditioned properly. Then out in Germany, my knee went because it did not have the proper muscle support.”
“I remember getting the call from the Newcastle chairman Freddy Shepherd while I was sat in the stand in Cologne and Michael was being treated by Gary Lewin out on the pitch,” recalls Bevington. “He was, how should I put it… less than impressed. I love Freddy dearly, but that wasn’t the warmest call I’ve had from him. I could hardly hear him, to be honest, but I could make out the occasional ‘You fucking this’, ‘You fucking that’ through the crowd noise. I didn’t really know what to say. What on earth did he want me to do?”
Owen had been deemed ready to feature. “At the time, there was a lot of argument saying he had obviously done his cruciate because he wasn’t fully fit,” says Lewin. “But what about the other 14 players every season who do their cruciate ligaments? You can’t say that about them. I can’t say it was, but I can’t look you in the eye and say it didn’t have a part to play in it, either.”
Much, of course, comes down to timing. Managers and their medical staff have to take calculated risks, particularly if a player has picked up a problem either late in the season or even in the pre-tournament friendlies and calculate when he might be ready to make a positive impact upon the tournament. Hodgson lost John Ruddy, Gary Cahill, Gareth Barry and Frank Lampard at Euro 2012 to injuries sustained immediately before the tournament, whether in friendlies or training, once they had been released into England’s care. None stood a chance of being ready.
On other occasions, head coaches have gambled. Zinedine Zidane tore his thigh in a warm-up match in South Korea before France’s defence of the World Cup in 2002, but was retained by Roger Lemerre in the hope he would play a more active role later in the tournament. However, by the time he was fit to return to action for the third group game, Les Bleus were on the brink of elimination. With his quadricep heavily strapped, Zidane cut a peripheral figure as France lost to Denmark and became the first reigning champions to fail to negotiate their group since Brazil in 1966.
Retreat further and the England manager, Ron Greenwood, opted to include Trevor Brooking and Kevin Keegan in his party for the 1982 World Cup in Spain, recognising them as his best players and likely to be gracing this stage for the last time, despite them arriving in Spain severely hampered by groin and back issues respectively. The room-mates painted a red cross on the door at the team hotel in Bilbao to signify theirs was effectively a hospital ward. Greenwood actually pulled Keegan to one side at breakfast one morning and asked him to start smiling more, fearing he was bringing down the mood of the entire group.
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The Hamburg striker’s issues were so severe that, with epidurals offering no relief and the first group stage of the tournament having passed without involvement, he requested to be able to fly back to West Germany — England’s next opponents — to be examined by the specialist, Jurgen Rehwinkel, whose treatment had seen him through the previous season. Greenwood and his team doctor needed some persuasion and only sanctioned the trip if it was undertaken in secrecy. Keegan duly crammed himself into a tiny Seat 500 in the middle of the night for the five-hour drive to Madrid to catch a 7am flight to Hamburg, all while wearing sunglasses and a hat to try and remain incognito. None of which did his back any good whatsoever.
He returned 48 hours later, his vertebrae massaged back into place, with the world apparently none the wiser — only to be left on the bench against West Germany. Both he and Brooking ended up being flung on against Spain, a game England needed to win to progress into the semi-finals, with 26 minutes to play. Keegan guided a header wide with virtually his first touch of the tournament. “But the manager took the risk because beat Spain and he would have had his two best players available for the semi-final,” adds Lewin. “If they had nicked that game 1-0, which they almost did, it might have felt like a masterstroke having those two fit and available.
“Back in 2014, Alex Oxlade-Chamberlain tweaked his medial knee ligament in Miami pre-tournament and we thought he’d be out for three weeks. That would have meant he’d be fit for the Costa Rica game, our last group fixture, and our view was that, if we’d brought someone over from England, they wouldn’t have trained for three or four weeks. So we were better off sticking with Alex and getting him fit for the knockout phase.
“As it turned out, we went out after two games and he never kicked a ball. We never got a chance to see if that was the right or wrong decision. But if we’d replaced him with a player who had not trained for a month, would you seriously have considered that player in any of the group games? Probably not.
“That’s the dilemma. That’s how complicated this process is. That is how brutal it can be. Nothing is ever simple.”
(Top pictures: Getty Images/Design:Thomas Slator)
